Tracie Henderson, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

1500 N 28TH St
Richmond, VA 23223-5332

Phone

(804) 764-7885

NPI assigned

May 13, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bon Secours Medical Group Richmond Specialty Care LLCGroup PAC ID 8022440056, 350 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bon Secours Medical Group Richmond Specialty Care LLC

  • Cardiovascular Disease Physician
  • Richmond, VA
  • NPI 1477112225
  Medicare reassignment Care Compare group NPD
• Bon Secours Medical Group Richmond Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Midlothian, VA
  • NPI 1841029287
  NPD
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1659018554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 GRASSY KNOLL LN",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232361716",
            "telephone_number": "804-385-9231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N 28TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232235332",
            "telephone_number": "804-764-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "TRACIE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylin Mae Henderson, KT
• Kendall Henderson
• Michael Henderson, LCSW
• Nell Christian Henderson
• Stephanie Henderson
• Vivian Priscilla Henderson
• Sandra B Hendrick, PHARMACIST
• Mack Piper Hendrix, M.D.
• Walter Cliff Hendrix IV, M.D.
• Annalee Helen Heneghan, LCSW

• Registered Dietitian in Richmond, VA
• Providers in Richmond, VA by specialty
• Registered Dietitian in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.